A University-Wide Preparedness Effort in the Alert Phase of COVID-19 Incorporating Community Mental Health and Task-Shifting Strategies: Experience from a Bornean Institute of Higher Learning.

The COVID-19 pandemic caught the world by surprise, causing millions of confirmed cases and hundreds of thousands of deaths. Hence, the Malaysian government announced a Movement Control Order at the start of the containment phase to flatten the epidemiological curve. Universiti Malaysia Sabah (UMS), a public university in Borneo, was accelerated into alert phase because of high risk of case importation from more than 400 China incoming undergraduates. Measures to mitigate the potential COVID-19 outbreaks in its population were taken by using conventional public health measures with special attention to task-shifting and widespread community mental health interventions. A Preparedness and Response Centre was established to overseer the mitigating measures happening inside the university. Measures taken included empowerment of frontline staff, strengthening of restrictions, strengthening university health center, vigorous contact tracing, widespread health education, maintaining cultural sensitivity, and establishment of early standard operating procedures and university continuity plans. Hence, UMS was able to ensure no importation of cases into its campus during both acute and containment phases at the nationwide level.

The Importance Of High Index Of Suspicion And Immediate Containment Of Suspected Covid-19 Cases In Institute Of Higher Education Sabah, Malaysia Borneo

@#Higher education institutions face major challenges in managing the impact of the COVID-19 pandemic. The risk of exposure from the community poses a threat to campus staff and students. This study describes epidemiological characteristics of suspected COVID-19 cases among a public university’s students and staff. This is a retrospective review on data collected from the institute’s COVID-19 Preparedness and Respond Centre, located at the main campus in Kota Kinabalu, the capital city of Sabah from mid-January to April 2020. Incidence rate was calculated, and epidemiological information retrieved from interviews and relevant documents. The majority of suspected COVID-19 cases were staff (57.1%) with incidence rates higher among males (IR=40.2/1,000 population) and those working in the frontline (IR=39.6/1,000 population). Suspected COVID-19 cases were mostly related to occupation (37.3%) and social contacts (27.3%). Student cases were largely related to household (38.1%) and during travel (33.3%). One positive COVID-19 case was reported of out of the 161 suspected cases (0.6%) in the institution. An operational team must be set up to conduct situational analysis and integrate management with other departments. Suspected COVID-19 cases must be quarantined and monitored on a daily basis. A high index of suspicion and effective containment of suspected cases will prevent spread of the virus among students and staff.

Denture Induced Submandibular Hematoma in a Patient on Warfarin.

A 79-year-old lady, who was taking warfarin, presented to the Emergency Department with a painless anterior neck swelling, which was associated with hoarseness of voice, odynophagia, and shortness of breath. She first noticed the swelling after she removed her dentures in the evening. On examination, she had an increased respiratory rate. There was a large submandibular swelling at the anterior side of her neck. Upon mouth opening, there was a hematoma at the base of her tongue, which extended to both sides of the tonsillar pillars. The patient was intubated with a video laryngoscope due to her worsening respiratory distress. Intravenous vitamin K and fresh frozen plasma were given immediately. The patient was admitted to the ICU for ventilation and observation. The hematoma subsided after 2 days and she was discharged well.